"Are you willing to stop
breastfeeding William?" I had heard those words before, and I couldn't
believe I was hearing them again. As the words reverberated in my head
all I could think of was, "How many times will my breastfeeding relationship
with William (and what I felt to be the very soul of our relationship)
be challenged?"

It was first challenged
when he was born prematurely, developed low blood sugar, and was quickly
sent to the special care nursery. I didn't get to breastfeed him until
eight hours after he was born. It was challenged again when he developed
jaundice, and I was told by his pediatrician to wean him temporarily,
which I did for several feedings until I got in contact with an LLL
Leader. She was able to calm my fears in my vulnerable emotional state,
and I resumed breastfeeding. Now, once again, another challenge.

This challenge occurred
in the most unlikely of placesthe pediatric dentist's office! My daughter,
Katherine, who is four now, had numerous cavities and even has one crown,
so I was sure to bring William in for his first checkup as soon as his
first few teeth appeared at about one year. At that point I heard the
bad news: four cavities in the top front four teeth.

After identifying the cavities,
Dr. Hale and I began talking. What could be the cause of dental caries
at such an early age? William's having so many cavities was somewhat
surprising. It wasn't as if I was feeding him candy, marshmallows, and
ice cream for breakfast, lunch, and dinner! In fact, William had very
few sweets and very little juice (mostly water, instead). He did nurse
on demand and William slept in our bed and nursed through the night.
Well, there, it was said. Dr. Hale had not been aware of this aspect
of our "attachment parenting" lifestyle with Katherine, but by the time
I took William in to see him, Dr. Hale and I had developed a close enough
relationship that I was able to be honest with him about our family's
lifestyle.

As I was later to learn,
frequency of night nursing may contribute to dental caries, particularly
if the baby is attached to the breast all night. It would be similar
to snacking many times during the night, not brushing your teeth, and
thereby providing an ideal environment for bad bacteria to flourish
in your mouth. No, breast milk doesn't leak from the breast as it does
from a bottle, but it may coat the teeth because the flow of saliva
which helps to clean the teeth is lower at night. The pH of the mouth
lowers and, in those who are susceptible, high acid producing bacteria
flourish. Next thing you know there are cavities. The percentage of
nursing mothers and babies affected by this is very small, but our family
ended up being one of the chosen few.

When Dr. Hale asked, "Are
you willing to stop breastfeeding William?" my answer was no. Breastfeeding
provides the best nutrition, the best immunological defense, and it's
part of our lifestyle. It's also one of the major ways I feel close
to my baby. Dr. Hale's remark turned out to be just a question after
all. Not a command, not an ultimatum, but one way in which Dr. Hale
tried to determine my feelings on the issue. Once he heard my "no" we
both tried to come up with a compromisehow to maintain the breastfeeding
relationship and preserve the health of William's teeth.

Because he felt the frequency
of nursing was a factor, Dr. Hale asked whether I could group breastfeeding
sessions together. I'm sure Dr. Hale didn't realize the practical impossibility
of this since he had never breastfed! With a clear understanding that
William was going to continue to nurse on demand day and night, Dr.
Hale suggested a routine in which we would try to keep his teeth immaculately
clean, wipe them with a cloth after every breastfeeding, brush his teeth
three to four times a day, and apply a small amount of topical fluoride
(being sure to wipe off the excess fluoride). Upon hearing this I immediately
felt relief. This was a solution that would allow us to continue breastfeeding
as much as we needed to and have healthy teeth for William as well.
Fear followed right behind. The proposed "program" sounded like far
too much work. With two children and a busy schedule, would we be able
to fit this in as well? William screamed through the once-a-day brushings
I was already doing. But I was determined not to have William experience
any more trauma from having more cavities filled. Since I was also very
upset during those fillings, I did not want to go through it again either.

So we started on this experimental
programwake up, brush his teeth, apply topical fluoride, nurse throughout
the day, keep a dry cloth handy, wipe his teeth after every nursing
(which he didn't like), go to sleep, nurse at night. I must confess
that I did not wake up at night to wipe his teeth with the dry cloth.
Other mothers who may have more stamina than I, go to it! But one of
the reasons William is in bed with us is so he can nurse and I don't
even have to wake up.

We continued this routine
for three months, had a checkup and no cavities. Then another three-month
checkup and no cavities. Six months with no cavities! Both Dr. Hale
and I were so happy it was as if we had won the lottery! Everyone in
the office was happy for us, and even William managed a smile.

I am convinced that honest
communication in which values were mutually respected made it possible
to arrive at a solution. We were successful beyond my wildest dreams,
and I can only hope our story helps other families in similar situations.
While the solution or technique to resolve dental caries may not be
the same in every situation, communication that respects everyone's
values is an essential ingredient in the resolution process.

And yes, William still protests
through every brushing, but at 21 months old he still nurses on demand,
is cavity-free, and oh, he has the sweetest smile.